| NPI | 1093263485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN HANSON Dentist 970-208-8046 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO DEN.00201846) |
| Enumeration Date | 2016-09-14 |
| Last Update Date | 2016-09-14 |